Therapeutic Gaming: A Practical Approach
Updated: Oct 7
A game in therapy should have a purpose you understand and a format you can choose. Perhaps you want another way to discuss asking for help, making a decision, or noticing frustration. A short shared activity might offer material for that conversation. You can also decide that talking directly would be more useful.
“Therapeutic gaming” is used in different ways. Ask what a clinician means by the term rather than assume that playing a particular game is a standardized treatment.
Begin with a goal
A useful starting point is a concern from your life, such as feeling unable to make a mistake at work or finding it difficult to ask someone for assistance. You and your therapist can discuss whether a game offers a relevant way to explore it.
The goal might be to notice your reaction to uncertainty or practice saying what you need. It should be more specific than “gaming will help my mental health.” Agree on what you want to learn and how you will review whether the activity was useful.
Clinical evidence needs to be tied to a specific game, population, and purpose. For example, a randomized study of the game Journey found no greater improvement in depressive symptoms among young people assigned to play it than in the comparison groups. Enjoying a commercial game does not, by itself, establish that it treats a mental health condition.
Choose the activity together
Consider what feels accessible and appropriate for you. Fast action, flashing visuals, complex controls, competition, or emotionally intense stories may make an activity a poor fit. A slower game is not automatically comfortable for everyone either.
You can ask about:
The reason for choosing this game or activity
Content you would prefer to avoid
Controls, sensory settings, and other access needs
How to pause, change the activity, or stop
Any account, purchase, privacy, or equipment requirements
Discuss those details before starting. You should not need to disclose personal information through a game account or buy something without understanding why it is being suggested.
Reflect without turning play into a test
Imagine, as a hypothetical example, that you become frustrated when a puzzle does not work on the first attempt. A useful question might be, “What was happening for you there?” Your answer could involve the puzzle's design, unfamiliar controls, tiredness, or something you recognize from daily life.
Your therapist should not assume that an in-game choice reveals a diagnosis, a hidden memory, or your personality. You decide whether an interpretation fits. You can disagree or say that there is nothing more you want to explore.
Reflection might also focus on what made participation easier: clearer instructions, a different pace, permission to ask a question, or changing the task. Those observations can inform a conversation even if you never finish the game.
Consider a small next step
If you identify something relevant, ask how it might apply outside the activity. Requesting help in a cooperative game may be easier than doing so at work, where relationships and consequences differ. A real-life step needs its own plan and should be safe and realistic.
You might draft a question to ask a colleague or identify the information you need before making a decision. There is no guarantee that a practiced skill will transfer automatically.
Outside sessions, pay attention to whether gaming supports or disrupts the life you want. WHO guidance on gaming disorder focuses on impaired control and significant interference with functioning. If play feels difficult to manage despite harm, discuss that with a mental health professional.
What this means at Tall Grass Therapy
I'm Dr. Corrine Buchanan, and I offer online therapy for adults in Florida and Oregon. In my geek-informed approach, games, stories, and roleplay are optional. You can ask about EMDR without using games, and including a game does not make EMDR more effective by default. We can choose an approach together and change it when it does not fit.
I'm not accepting new therapy clients right now. Join the waitlist through Paubox.
